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(reply to Anonymous)

Hello Luke,
You ask some good questions especially since most of them revolve around the high risk strains of HPV. The genital warts caused mainly by HPV16 and 18 are not the same type of wart that you get on your hands. Those are caused by other strains of HPV which are not genitally related. While there are over 100 different strains of HPV about forty are considered sexually related. Of those approximately 14, to date, are considered high risk for dysplasia and cancer.
There is still much controvery when it comes to certain aspects of the virus but there is no controversy what-so-ever when it comes to the allowable age (per the FDA) that an individual can receive the vaccine and that is 26. If I were you, I would go to my website, thehpvsupportnetwork.org and go to the Resource page. You will find numeros links for Merck that provide financal assistance for those who cannot afford it. However, the website also allows you to print out the vaccine information and administration sheet (which comes along with the vaccine when it is sent to the doctor). It clearly states the ages of administration whether men or women is from 9 to 26. I'd take this to your doctor's and ask for an explanation regarding their prior suggestion. Unless people start calling doctors out on their spread of erroneous information it will only continue. This may not seem like a big issue but who knows what other HPV related information is incorrect and being given to patient's by this doctor. Merck had hoped that the FDA would extend the higher age range to 45. Mrck has applied to the FDA to extend the age three times and unfortunately the FDA again refused to extend the age of the vaccine. Now I'll confuse you a bit more because technically you still can get the vaccine at any age but it will only be covered by insurance until the FDA approved age which is 26. This is referred to receiving the vaccine "off label". You would have to then pay for it yourself (3 vaccine series at about $150 each). Not all doctors will give the vaccine off label. You may want to ask your doctor if they were talking about getting the vaccine off label first. If they didn't mention these words to you or that you would have to pay for it yourself chances are they're just wrong in their answer as opposed to thinking about you getting it off label. At least you'll have the info either way.
As for your questions, chances are you may also have high risk strains of HPV as well as the low risk wart strains. It is important to use condoms to reduce transmission but this only relates to the covered area and since the virus can be harboured in so much surrounding tissue one may feel like they are fighting a losing battle. However there are more significant reasons for using condoms as it relates to the woman. HPV DNA has been found in semen. If a woman has HPV and continually has what is referred to as the "viral load" increased through continued exposure to your semen, this could cause a negative impact on her immune system resulting in a recurrence if her HPV has been dormant.
They used to say that you could not get herpes unless you were having an outbreak. This has since been shown not to be the case. Like HPV, herpes is also a virus and one that goes dormant and reappears as well. While there is nothing definitive on this, I certainly would pursue any relations from the standpoint that it can be transmitted at any time. Better to be safe than sorry when they tell us differently five years from now.
Obvioulsy there is a significant connection between stress and the immune system. High stress levels and pregnancy during which the immune system is lowered tend to be times when someone with HPV will get a recurrence or will be initially diagnosed. If you are dealing with a lot of stress then that will result in a weakened immune system but that doesn't necessarily mean it is a permanent situation. Once the stress is reduced the immune system can get back to normal again.
Just as an example, in studies done on those with HPV AND AIDS it was found that one stressful incident resulted in a two fold progression of disease while two or more stressful incidents (during the same monitored time period) showed a six-fold increase in progression. So obviously multiple stressful incidents can affect progression of HPV. I'm certain to some degree this would be true even if you didn't have AIDS.
As for your relationship, 80% of the population will have some issue with an HPV infection at some time in their lives. Chances are she may already have HPV and you certainly could discuss her own history with pap tests and HPV screening. I'd suggest you have her request an HPV screening at her next visit. Normally they are not done on women under 30 so she would need to let the doctor know she is involved with someone who has known HPV and wants to be sure herself. Even if her test comes up positive, most women under 30 end up with the virus going dormant.
I can't really say there are no tests for men because men are getting anal paps every day in this country. It is very difficult to obtain one because the American Society for Colon and Rectal Surgeons does not educate their members on the true dangers of HPV and tend to minimize it as being of little concern at all. Many of them haven't a clue what to do for a patient with HPV let alone one who develops anal cancer from it like I did.
I admire you for wanting to sit down and talk with your partner. Many people want to hide it because of their own shame without thinking about the potential cancer risk to their partner. Some doctors even tll patients they don't need to inform their partners which in my opinion is negligent pure and simple. She has a right to know and to choose whether or not she wants to be exposed to this virus.
I hope this has answered your questions. Please feel free to PM me if you have any additional questions.

May 9, 2011 - 11:23pm


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